Lake Family Medical Practice Pc | |
201 Portion Rd Ste A Lake Ronkonkoma NY 11779-4172 | |
(631) 981-1333 | |
(631) 981-2326 |
Full Name | Lake Family Medical Practice Pc |
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Speciality | Family Medicine |
Location | 201 Portion Rd Ste A, Lake Ronkonkoma, New York |
Authorized Official Name and Position | Robert A Tufano (CEO) |
Authorized Official Contact | 6319811333 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Lake Family Medical Practice Pc 201 Portion Rd Ste A Lake Ronkonkoma NY 11779-4172 Ph: (631) 981-1333 | Lake Family Medical Practice Pc 201 Portion Rd Ste A Lake Ronkonkoma NY 11779-4172 Ph: (631) 981-1333 |
NPI Number | 1639923675 |
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Provider Enumeration Date | 04/16/2024 |
Last Update Date | 11/13/2024 |
Medicare PECOS PAC ID | 9436684065 |
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Medicare Enrollment ID | O20241120000048 |
Identifier | Type | State | Issuer |
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1639923675 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Robert A Tufano |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1851442966 PECOS PAC ID: 4183884950 Enrollment ID: I20120402000518 |
Ismail Ozcan Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 95 Church St, Lake Ronkonkoma, NY 11779 Phone: 631-588-6665 Fax: 631-580-5543 | |
Theodore Fried Burford Welch & David Hauer Md, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 388 Hawkins Ave, Suite 1, Lake Ronkonkoma, NY 11779 Phone: 631-588-8460 Fax: 631-588-8480 | |
Rakesh Sharma Physician Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 122 Portion Rd, Suite 104, Lake Ronkonkoma, NY 11779 Phone: 631-588-8393 Fax: 631-588-2312 | |
Michael Creta, Do Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 290 Hawkins Ave, Lake Ronkonkoma, NY 11779 Phone: 631-981-0045 Fax: 631-981-1117 |